Adult Health Chapter 41 EAQ Questions, adult sh*t
An obese patient receives a prescription for orlistat for weight loss. What should the nurse include in the patient's medication teaching? A. "Take folic acid supplements." B. "Take vitamin supplements." C. "Consume a high-calorie diet." D. "Take a stool softener."
B Orlistat is a nutrition absorption-blocking drug that acts by blocking fat breakdown and absorption in the intestine. Fat-soluble vitamins may also decrease in patients taking this medication. Therefore, the nurse instructs the patient to take vitamin supplements. Orlistat may cause diarrhea; therefore, the nurse should not instruct the patient to take a stool softener, because it would aggravate diarrhea. The patient is obese, so a high-calorie diet should not be recommended. The patient who is on orlistat will not experience a folic acid deficiency or anemia.
The nurse calculates a patient's body mass index (BMI) to be 27 kg/m2. This BMI would fall under which classification? A. Obese B. Overweight C. Normal body weight D. Underweight
B The most common measure of obesity is the body mass index (BMI). BMI is calculated by dividing a person's weight (in kilograms) by the square of the height in meters. Individuals with a BMI less than 18.5 kg/m2 are considered underweight, whereas those with a BMI between 18.5 and 24.9 kg/m2 reflect a normal body weight. A BMI of 25 to 29.9 kg/m2 is classified as being overweight, and those with values at 30 kg/m2 or above are considered obese. The term severely (morbidly, extremely) obese is used for those with a BMI greater than 40 kg/m2.
During care of the patient with extreme obesity, what is most important for the nurse to do? a avoid any reference to the patient's weight to avoid embarrassing the patient b emphasize to the patient how important it is to lose weight to maintain health c plan for necessary modifications in equipment and nursing techniques for starting care d recognize that a full assessment may not be possible because of numerous layers of skinfolds
C
The nurse determines that further discharge instruction is needed when the patient with acute pancreatitis makes which statement? a I should observe for fat in my stools b I must not use alcohol to prevent future attacks of pancreatitis c I shouldn't eat any salty foods or foods with high amounts of sodium d I will not need to monitor my blood glucose levels when I am at home
C
The nurse working in a health care facility where uniform electronic health records are used explains to the patient that the primary purpose of such a record is to a reduce the cost of health care by eliminating paper records b keep the patient's medical information more private than handwritten records c provide a single place for health care members to review, update, document, and order patient care d provide a single record, making the patient's medical information accessible to any care givers in any health system
C
What describes the primary difference in treatment for DKA and hyperosmolar hyperglycemic syndrome (HHS)? a DKA required administration of bicarbonate to correct acidosis b potassium replacement is not necessary in management of HHS c HHS requires greater fluid replacement to correct dehydration d glucose is withheld in HHS until the blood glucose reaches a normal level
C
What is the most challenging nursing interventions to promote healing in the patient with viral hepatitis? a providing adequate nutritional intake b promoting strict bed rest during the icteric phase c providing pain relief without using liver-metabolizing drugs d providing quiet diversional activities during periods of fatigue
C
What should the nurse include when teaching the patient with COPD about the need for physical exercise? a all patients with COPD should be able to increase walking gradually up to 20 min. per day b a bronchodilator inhaler should be used to relieve exercise-induced dyspnea immediately after exercise c shortness of breath is expected during exercise but should return to baseline within 5 minutes after the exercise d monitoring the heart rate before and after exercise is the best wat to determine how much exercise can be tolerated
C
Which breathing technique should the nurse teach the patient with moderate COPD to promote exhalation? a huff coughing b thoracic breathing c pursed lip breathing d diaphragmatic breathing
C
The nurse is caring for a 45-year-old woman with a herniated lumbar disc. The patient realizes that weight loss is necessary to lessen back strain. The patient is 5'6" tall and weighs 186 lb (84.5 kg) with a body mass index (BMI) of 28 kg/m2. The nurse explains to the patient that this measurement places her in which of the following weight categories? A. Severely obese B. Obese C. Overweight D. Normal weight
C A normal BMI is 18.5 to 24.9 kg/m2, whereas a BMI of 25 to 29.9 kg/m2is considered overweight. A BMI of 30.0 to 39.9 is considered obese and a BMI of 40 or greater is severely obese.
The nurse determines that an obese patient has obesity hypoventilation syndrome. Which body condition creates a high risk for this condition? A. Secondary obesity B. Primary obesity C. Android body shape D. Gynoid body shape
C A patient with android obesity will have fat deposition around the diaphragm and in the neck and chest, creating a higher risk for obesity-related hypoventilation. A patient with gynoid obesity has excess fat depositions in the upper legs, which does not result in a higher risk of obesity hypoventilation syndrome. A person with either primary obesity or secondary obesity may develop obesity hypoventilation syndrome; however, the syndrome is associated with where fat accumulates on the body rather than the specific cause (primary or secondary) of the patient's obesity.
An overweight patient admitted to the hospital for heart failure weighs 192 pounds. The nurse instructs the patient that an acceptable portion size of animal protein is approximately how many ounces? A. 7 ounces B. 5 ounces C. 3 ounces D. 1 ounce
C An appropriate serving size of animal protein is 3 ounces, about the size of one's fist. 1 ounce is one third of the normal serving size; 5 and 7 ounces are greater than one serving size.
What is a cause of primary hypothyroidism in adults? a malignant or benign thyroid nodules b surgical removal or failure of the pituitary gland c surgical removal or radiation of the thyroid gland d autoimmune-induced atrophy of the thyroid gland
D
What is a postoperative nursing intervention for the obese patient who has had bariatric surgery? a irrigation and repositioning the NG tube as needed b delaying ambulation until the patient has enough strength to support self c keeping the patient positioned on the side to facilitate respiratory function d providing adequate support to the incision during coughing and deep breathing
D
What is the initial antibiotic treatment for pneumonia based on? a the severity of symptoms b the presence of characteristic leukocytes c gram stains and cultures of sputum specimens d history and physical examination and characteristic chest x-ray findings
D
During patient teaching, the nurse emphasizes that a healthy weight loss averages how many pounds per week? A. Eight pounds B. Six pounds C. Four pounds D. Two pounds
D A realistic weight loss goal is one to two pounds per week, which prevents the patient from becoming frustrated at not meeting weight loss goals. Also, it is not so rapid that the patient's skin and underlying tissue lose elasticity and become flabby.
A patient with diabetes calls the clinic because she has nausea and flu-like symptoms. Which advice from the nurse will be the best for this patient? a administer the usual insulin dosage b hold fluid intake until the nausea subsides c come to the clinic immediately for evaluation and treatment d monitor the blood glucose every 1-2 hours and call if it rises over 150mg/dL
A
Before selecting a weight reduction plan with an obese patient, what is most important for the nurse to first assess? a the patient's motivation to lose weight b the length of time that the patient has been obese c whether financial considerations will affect the patient's choices d the patient's height, weight, BMI, waist-to-hip ratio, and skinfold thickness
A
The patient with suspected gallbladder disease is scheduled for an ultrasound of the gallbladder. What should the nurse teach the patient about this test? a it is noninvasive and is a very reliable method of detecting gallstones b it is the only test to use when the patient is allergic to contrast medium c it will outline the gallbladder and the ductal system to enable visualization of stones d it is an adjunct to liver function tests to determine whether the gallbladder is inflamed
A
Two days after a self-managed hypoglycemic episode at home, the patient tells the nurse that his blood glucose levels since the episode have been between 80-90mg/dL. Which is the best response by the nurse? a that is a good range for your glucose levels b you should call your HCP because you need to have your insulin increased c that level is too low in view of you recent hypoglycemia and you should increase your food intake d you should take only half your insulin dosage for the next few days to get your glucose level back to normal.
A
What is the most challenging nursing interventions to promote healing in the patient with viral hepatitis? a providing adequate nutritional intake b promoting strict bed rest during the icteric phase c providing pain relief without using liver-metabolizing drugs d providing quiet diversional activities during periods of fatigue
A
What preoperative instruction should the nurse give to the patient scheduled for a subtotal thyroidectomy? a how to support the head with the hands when turning in bed b coughing should be avoided to prevent pressure on the incision c head and neck will have to remain immobile until the incision heals d any tingling around the lips or in the fingers after surgery is expected and temporary
A
What treatment for acute cholecystitis will prevent further stimulation of the gallbladder? a NPO with NG suction b incisional cholecystectomy c administration of antiemetics d administration of anticholinergics
A
Which statement accurately describes Graves' disease? a exophthalmos occurs in Graves' disease b it is an uncommon form of hyperthyroidism c manifestations of hyperthyroidism occur from tissue desensitization to the sympathetic nervous system d diagnostic testing in the patient with Graves' disease will reveal an increased thyroid-stimulating hormone level
A
A 58-year-old man with chronic low back pain realizes he needs to reduce his weight to lessen the back pain and strain. He is 6 feet tall and weighs 218 pounds. The nurse interprets that the patient currently is classified as overweight, which correlates to which body mass index (BMI) range? A. 25 to 29 B. 35 to 40 C. 30 to 34 D. 18 to 24
A A normal BMI is 18.5 to 24.9 kg/m2, and a BMI of 25 to 29.9 is considered overweight. A BMI of 30 to 34 indicates obesity, and more than 35 indicates morbid obesity.
The nurse reviews the laboratory reports of an obese patient who is diagnosed with gout. Which finding does the nurse associate with the patient's condition? A. Hyperuricemia B. Hyponatremia C. Hyperkalemia D. Hypovolemia
A A patient with gout will have crystallization of uric acid, which is deposited in joints and causes inflammation. This condition is associated with hyperuricemia. Obesity and gout are not associated with loss of blood or hypovolemia. Obesity and gout do not affect the potassium and sodium electrolyte balance. Therefore, hyperkalemia and hyponatremia are not observed in obese patients who are diagnosed with gout.
A patient has a body mass index (BMI) of 27. The nurse has discussed weight-loss goals with the patient. Which statement made by the patient indicates proper understanding of the teaching? A. "I will begin to steam and broil my foods for most meals." B. "I will increase my intake of sugar-free foods and beverages." C. "I will limit intake to 500 calories per day." D. "I will exercise for 15 minutes every day of the week."
A Broiling and steaming foods is a healthier way to prepare meals. Limiting intake to 500 calories per day is not indicated for this patient, and the severe calorie-energy restriction would place the patient at risk for multiple nutrient deficiencies. Low-calorie diets are defined as those having 800 to 1200 calories per day. Exercise should be at least 30 minutes per day.
What is the reason behind primary obesity? A. The intake of calories over the metabolic demand B. The presence of lesions in the central nervous system C. The presence of congenital abnormalities D. The development of metabolic disorders
A Excess calorie intake over energy expenditure for the body's metabolic demands causes primary obesity. Metabolic disorders, congenital abnormalities, and lesions in the central nervous system can result in secondary obesity.
The nurse is prescribing a diet to promote weight loss to an obese patient. Which advice is the most appropriate? A. Include fruits and vegetables in each meal. B. Reduce fiber intake, which can cause digestion complications. C. Avoid steamed foods, which removes much of the nutrients. D. Use whole milk, which has more vitamin D
A Including adequate fruits and vegetables will the help the patient to maintain a lower calorie intake as well as providing essential nutrients. Whole milk is not advisable for losing weight and should be replaced with low-fat or skim milk as required. Steaming foods can help to reduce fat intake and aid in weight loss. Reducing fiber intake will not help with weight loss; instead, consumption of fiber and bulk-forming foods is recommended.
A patient who is scheduled for gastric bypass surgery asks for information about dumping syndrome. How should the nurse explain dumping syndrome? A. When the passage of food into the jejunum occurs too rapidly B. An increase in the secretion of both bile and pancreatic enzymes C. A decrease in the secretion of insulin caused by carbohydrates D. The inability to digest high-fat foods
A It is believed that the cause of dumping syndrome is the passage of undiluted food into the jejunum. This causes a surge of insulin to be released, resulting in the symptoms of profuse sweating, nausea, dizziness, and weakness. Dumping syndrome is frequently seen in patients who have undergone subtotal gastrectomy or gastric bypass surgery. Dumping syndrome is not caused by an inability to digest high-fat foods, a decrease in the secretion of insulin, or an increase in the secretion of bile and pancreatic enzymes.
The nurse recognizes that which surgical procedure is most effective in enhancing facial appearance after weight loss? A. Liposuction B. Malabsorptive surgery C. Restrictive surgery D. Lipectomy
A Liposuction is a cosmetic surgery that helps improve facial appearance around the chin, jaw, and nasal folds after weight loss. Lipectomy is a cosmetic surgery that improves body image. It is effective for the breasts, abdomen, and lumbar and femoral areas, but not the facial areas. Restrictive and malabsorptive surgeries are bariatric surgeries, which reduce the size of the stomach but do not affect the facial appearance.
The nurse identifies that a patient who is taking medication for weight loss is at high risk of drug abuse. This determination was made based on the patient's history of taking which medication? A. Nonamphetamines B. Nutrient absorption-blocking drugs C. Serotonin agonists D. Antidiabetic drugs
A Nonamphetamines are sympathomimetic drugs that should only be used short-term because of the potential for drug abuse. Antidiabetic drugs, serotonin agonists, and nutrient absorption-blocking drugs help reduce weight effectively, and the patient is not at an increased risk of abuse.
Which complication due to weight loss can be reduced with reconstructive surgery? A. Altered body image B. Deep venous thrombosis C. Dumping syndrome D. Cardiopulmonary
A Reconstructive surgery is a surgical procedure that helps retain previous body image, form, and function. The patient who has cardiopulmonary complications will have effective treatment with the jaw-thrust maneuver and proper airway support. The nurse instructs the patient to restrict fluid with meals to prevent dumping syndrome. The patient with deep venous thrombosis will have effective treatment with low-dose heparin.
The severely obese patient has elected to have the Roux-en-Y gastric bypass (RYGB) procedure. The nurse will know the patient understands the preoperative teaching when the patient makes which statement? A. "This surgery decreases how much I can eat and how many calories I can absorb." B. "This surgery can be modified whenever I need it to be changed." C. "This surgery will remove the fat cells from my abdomen." D. "This surgery will preserve the function of my stomach."
A The RYGB decreases the size of the stomach to a gastric pouch and attaches it directly to the small intestine so food bypasses 90% of the stomach, the duodenum, and a small segment of the jejunum. The vertical sleeve gastrectomy removes 85% of the stomach, but preserves the function of the stomach. Lipectomy and liposuction remove fat tissue from the abdomen or other areas. Adjustable gastric banding can be modified or reversed at a later date.
Why does the nurse instruct a patient who has undergone bariatric surgery to restrict the oral intake of food for a few days? A. To reduce the risk of abdominal distention B. To reduce the risk of dumping syndrome C. To reduce the risk of venous stasis D. To reduce the risk of hernia
A The patient has undergone bariatric surgery. Therefore, oral intake of food should be restricted to reduce the risk of abdominal distention, which occurs due to the inability to digested food. The presence of sutures after surgery will increase the risk of hernia. Venous stasis is the condition of slow blood flow in the veins that may arise due to bed rest and an increase in body fat. The nurse instructs the patient to avoid drinking water with meals to prevent dumping syndrome.
When teaching the patient about the use of weight-reducing drug therapy, what instructions should the nurse include? Select all that apply. A. Understand the side effects of drug therapy. B. Understand that diet and exercise are important for permanent weight loss. C. Avoid modification of the drug dosage without medical advice. D. Weight loss caused by weight-reducing drugs is permanent. E. Utilize any of the available over-the-counter weight loss drugs.
A, B, C The patient should be taught about proper administration and side effects of the drug, to avoid modification of dosage without medical advice, and that diet and exercise regimens are the cornerstones of permanent weight loss. Purchase or use of any over-the-counter weight loss drug is not advisable. The nurse should explain that the weight loss caused by weight-reducing drugs is not permanent.
When teaching a patient about reducing weight by using a calorie-restricted diet, what instructions should the nurse include? Select all that apply. A. Select steamed and baked foods. B. Select fried and greasy foods. C. Avoid concentrated sweets. D. Exercise regularly. E. Skip meals if not hungry.
A, C, D To follow a calorie-restricted diet to reduce weight, the patient should exercise regularly; avoid concentrated sweets such as sugar, candy, honey, pies, cakes, cookies, and regular sodas; and eat steamed and baked foods. It is not advisable to skip meals or to consume fried and greasy foods.
The nurse is admitting a patient for bariatric surgery. Which finding in a patient's history should be brough to the surgeon's attention before proceeding with further patient preparation? a hypertension b untreated depression c multiple attempts to lose weight d sleep apnea treated with CPAP
B
The nurse is assessing a newly admitted patient with diabetes. Which observation should be addressed as the priority by the nurse? a bilateral numbness of both hands b rapid respirations with deep inspiration c stage II pressure injury on the right heel d areas of lumps and dents on the abdomen
B
When guiding nursing in how to perform professionally, which describes a competent level of nursing care based on the nursing process? a Standards of Professional Performance b Standards of Practice c Quality and Safety Education for Nurses d State Nurse Practice Act
B
Which complication of acute pancreatitis requires prompt surgical drainage to prevent sepsis? a tetany b pseudocyst c pleural effusions d pancreatic abscess
D
The nurse is caring for a patient with COPD, which intervention could be delegated to unlicensed assistive personnel? a assist the patient to get out of bed b auscultate breath sounds every four hours c plan patient activities to minimize exertion d teach the patient pursed-lip breathing technique
A
A 36-year-old patient with type 1 diabetes mellites asks the nurse whether an influenza vaccine is necessary every year. What is the best response by the nurse? a You should get the inactivated influenza vaccine that is injected every year. b Only health care workers in contact with high-risk patients should be immunized each year c An annual vaccination is not necessary because previous immunity will protect you for several years d Antiviral drugs, such as zanamivir, eliminate the need for vaccine except in the older adult
A
A patient with pneumonia is having difficulty clearing the airway because of pain, fatigue, and thick secretions. What is an expected outcome for this patient? a SpO2 is 90% b lungs clear to auscultation c obtain the pneumococcal vaccine if he is exposed to individuals with pneumonia d obtain only the influenza vaccine every year because he should have immunity to the pneumococcus because of his age
B
A patient has been on a 1000-calorie diet with a daily exercise routine. In 2 months, the patient has lost 20lbs toward a goal of 50lbs but is now discouraged that no weight has been lost in the last 2 weeks. What should the nurse tell the patient about this? a a steady weight may be caused by water gain from eating foods high in sodium b plateaus where not weight is lost normally occur during a weight loss program c a weight considered by the body to be most efficient for functioning has been reached d a return to former eating habits is the most common cause of not continuing to lose weight
B
A patient with cirrhosis that is refractory to other treatments for esophageal varices undergoes a splenorenal shunt. Because of this procedure, what should the nurse expect the patient to experience? a an improved survival rate b decreased serum ammonia levels c improved metabolism of nutrients d improved hemodynamic function and renal perfusion
B
A patient with hypothyroidism is treated with levothyroxine. What should the nurse include with teaching the patient about this therapy? a explain that alternate-day dosage may be used if side effects occur b provide written instruction for all information related to the drug therapy c tell the patient that the drug must be taken until the hormone balance is reestablished
B
When medications are used in the treatment of obesity, what is most important for the nurse to teach the patient? a over-the-counter diet aids are safer than other agents and can be useful in controlling appetite b drugs should be used only as adjuncts to a diet and exercise program as treatment for a chronic condition c all drugs used for weight control can affect central nervous system function and should be used with caution d the primary effect of medications is psychologic, controlling the urge to eat in response to feelings of rejection
B
The nurse concludes that a patient has metabolic syndrome based on what abnormal laboratory result? A. White blood cell count B. Cholesterol levels C. Creatinine levels D. Platelet count
B A patient with metabolic syndrome will have abnormal lipid or cholesterol levels, because the metabolism is affected. A patient with an abnormality in his or her bone marrow may show an abnormal platelet count. A patient with kidney impairment or cardiovascular disease will have abnormal creatinine levels, but not metabolic syndrome. A patient who has an infection will have an abnormal white blood cell count.
The nurse identifies that a patient who has visceral fat with truncal obesity is at risk for what disease? A. Gastrointestinal disease B. Cardiovascular disease C. Genitourinary disease D. Reproductive disease
B A patient with truncal obesity will have excess fat in the chest. Therefore, the patient has a high risk of cardiovascular disease. A patient who is pear-shaped or has excess fat in the upper thighs will have a high risk of reproductive and genitourinary disease. A patient who has excess fat depositions in the abdomen will have a risk of gastrointestinal disease.
The nurse is reviewing cultural and ethnic factors related to obesity. Which statement does the nurse identify as being true? A. Asian Americans have the same prevalence of being overweight and obese compared with the general population. B. Among women, African Americans have the highest prevalence of being overweight or obese. C. Native Americans have a lower prevalence of being overweight than the general population. D. Among men, Mexican Americans have the lowest prevalence of being overweight or obese.
B African Americans and Hispanics have a higher prevalence of obesity than whites. Among women, African Americans have the highest prevalence of being overweight or obese, and 15% are severely obese. Among men, Mexican Americans have the highest prevalence of being overweight or obese. Native Americans have a higher prevalence of being overweight than the general population. Asian Americans have the lowest prevalence of being overweight and obese compared with the general population.
A patient is admitted to the hospital with acute thyrotoxicosis. On physical assessment of the patient, what should the nurse expect to find? a hoarseness and laryngeal stridor b bulging eyeballs and dysrhythmias c increased temperature and signs of heart failure d lethargy progressing suddenly to impaired consciousness
C
What medication is given in thyrotoxicosis to block the effects of the sympathetic nervous stimulation of the thyroid hormones? a potassium iodine b propylthiouracil c propranolol d radioactive iodine
C
The nurse provides education to a patient about reducing the risk of obesity. Which statement made by the patient indicates the need for further teaching? A. "I should include a cup of low-fat milk at breakfast." B. "I should eat vegetables and salad at lunch and dinner." C. "I should incorporate canned fruits into my everyday diet." D. "I should eat two ounces of baked chicken for dinner."
C Canned fruits contain excess sugars, so the patient will have a higher risk of obesity. Therefore, the patient should avoid canned fruits. Two ounces of baked chicken should be included with dinner, because baked foods have a lower fat content. Vegetables and salads should be included in the diet, because vegetables contain protein and vitamins for effective growth. Low-fat milk does not contain excess fat and provides adequate calcium for development, so it should be included in the diet.
Two weeks after a subtotal gastrectomy, a patient reports the sudden onset of clammy skin, weakness, and diaphoresis after a meal. What diagnosis does the nurse suspect? A. Mesenteric artery embolism B. Acute myocardial infarction C. Dumping syndrome D. Acute pancreatitis
C Dumping syndrome is the most likely cause of these symptoms about two weeks after surgery. Dumping syndrome is believed to be caused by food directly entering the jejunum without first being processed in the stomach. Acute pancreatitis would present with acute abdominal pain, nausea, vomiting, and tachycardia. In addition to complaints of feeling clammy, weak, and diaphoretic, an acute myocardial infarction would likely manifest with chest pain and pressure. Mesenteric artery embolism would also manifest as nausea, vomiting, and abdominal pain. The nurse should further question the patient to determine the cause of the episode, including other associated symptoms and what types and quantities of foods were eaten at the meal.
An obese patient is scheduled for cosmetic surgery for body image enhancement. The nurse provides education about reducing the risk of obesity recurrence. Which statement made by the patient indicates the need for further teaching? A. "I need to drink low-fat milk and eat salads." B. "I need to exercise every day." C. "I can eat candy and honey as I wish." D. "I can include baked food in my diet."
C The patient is undergoing a lipectomy, which is a cosmetic surgery to reduce body fat. However, there is still a risk of recurrence of obesity unless the patient maintains a proper diet. Candies and honey contain excess sugar, which increases the risk of obesity. Therefore, the patient should prefer fresh fruits to candies. Baked foods are lower in fat, so they can be included in the diet. Exercise is necessary to maintain proper body structure and reduce the risk of obesity. Low-fat milk and salads provide adequate nutrition and reduce the risk of obesity.
The nurse is teaching a patient about developing strategies to plan a weight loss program. What nursing actions are appropriate? Select all that apply. A. Advise medication and surgery. B. Advise diet therapy alone. C. Advise focusing on reasons to lose weight. D. Suggest lifestyle changes. E. Modify diet, exercise, and behavior
C, D, E For successful weight loss, lifestyle changes such as healthy eating habits and adequate physical activity should be stressed. It is also important to focus on reasons to lose weight. A multifaceted approach needs to be used and will include nutritional therapy, exercise, and behavior modification. Advising diet therapy or medication and surgical intervention for all patients is not recommended.
After a laparoscopic cholecystectomy, what should the nurse expect to be part of the plan of care? a return to work in 2-3 weeks b be hospitalized for 3-5 days postoperatively c have a t-tube placed in the common bile duct to provide bile drainage d have up to 4 small abdominal incisions covered with small dressings
D
Following the teaching of foot care to a patient with diabetes, the nurse determines that additional instruction is needed when the patient makes which statement? a I should wash my feet daily with soap and water b I should always wear shoes to protect my feet from injury c if my feet are cold, I should wear socks instead of using a heating pad d I'll know if I have sores or lesions on my feet because they will be painful
D
In addition to promoting the transport of glucose from the blood into the cell, what does insulin do? a enhances the breakdown of adipose tissue for energy b stimulates hepatic glycogenolysis and gluconeogenesis c prevents the transport of triglycerides into adipose tissue d increases amino acid transport into cells and protein synthesis
D
In addition to smoking cessation, what treatment is included for COPD to slow the progression of the disease? a use of bronchodilator drugs b use of inhaled corticosteroids c lung volume reduction surgery d prevention of respiratory tract infections
D
The occurrence of acute liver failure is most common in which situation? a a person with hepatitis A b A person with hepatitis C c antihypertensive medication use d use of acetaminophen with alcohol use
D
Two nurses are establishing a smoking cessation program to assist patients with chronic lung disease to stop smoking. To offer the most effective program with the best outcomes, the nurses should initially a search for an article that describes nursing interventions that are effective for smoking cessation b develop a clinical question that will allow patients to compare different cessation methods during the program c keep comprehensive records that detail each patient's progress and ultimate outcomes from participation in the program d use evidence-based clinical practice guidelines developed from randomized controlled trials of smoking cessation methods
D
In developing a weight-reduction plan for an overweight patient it is important for the nurse to first assess the presence of which factor? A. The patient's current employment status B. The patient's waist-to-hip circumference ratio C. The patient's current body mass index (BMI) D. The patient's readiness to make lifestyle changes
D Eating patterns are established early in life, and eating has many meanings for people. To establish a weight-reduction plan that will be successful for the patient, the nurse should first explore the social, emotional, and behavioral influences on the patient's eating patterns. Current BMI, waist-to-hip circumference, and employment status are not correlated with success of weight loss or the development of a weight loss plan.
The nurse is caring for a patient who is 5'6" tall and weighs 186 lb. The nurse has discussed reasonable weight loss goals and a low-calorie diet with the patient. Which statement made by the patient indicates a need for further teaching? A. "It's important for me to begin a regular exercise program." B. "I'll try to pick foods from all of the basic food groups." C. "I will try to eat very slowly during mealtimes." D. "I will limit intake to 500 calories a day."
D Limiting intake to 500 calories per day is not indicated for this patient and the severe calorie energy restriction would place this patient at risk for multiple nutrient deficiencies. Decreasing caloric intake of at least 500 to 1000 calories a day is recommended for weight loss of one to two pounds per week. The statements about eating slowly, picking food from basic food groups, and adhering to an exercise program indicate that the patient understands methods to aid in weight loss.
A nurse is teaching an elderly patient that aging problems can be exacerbated by obesity. Which condition should the nurse include as being affected by obesity? A. Chewing difficulty B. Vision problems C. Sinusitis D. Arthritis
D Obesity can place more demands on arthritic joints, and the mechanical strain on weight-bearing joints can lead to premature immobility, thereby exacerbating arthritis. Sinusitis, vision problems, and chewing difficulty are not related to obesity.
Most common cause of chronic liver disease and liver failure. What is the most common reason for liver transplantation in the US.
Hepatitis C
